Just because you can…

Just because you can, doesn’t mean you should. That piece of ethical sense seems to escape a lot of people—especially in the medical community.


How about the artificial insemination that resulted in octuplets being born to a single mother (with no means to support her children) who already had sextuplets from a previous artificial insemination? Wasn’t that a breach of medical ethics?


It can be argued that such cases of medical ethics are not mine to judge. I can, however, judge something much closer to home: The medical treatment of my 96-year-old mother-in-law.


For a person her age, she is in remarkably good health. She gets up early every morning; puts on makeup; and take a mini-bus to the senior center. Once a week she arranges a mini-bus ride to have her hair done. She exercises on the Gazelle every day. And when the weather cooperates, she takes a walk around the neighborhood, pushing her walker and resting when she needs to.

She is like the pink bunny in the battery commercial: She just keeps on going.


Although she looks at least 15 years young than her age, her body almost 97 years old. And inevitably, it is wearing down. She is unrealistic does not want to accept that fact. She believes that problems—such as her urinary incontinence—can be fixed the same as they were when she was 75. So she asked a urologist to fix the problem.


He tried some relatively noninvasive procedures, which did not work (no surprise). Then instead of saying “no” to her request, he agreed to perform a surgical procedure to fix the problem.


In a younger woman, the type of surgery he proposed is considered safe, easy, and effective—in and out of the hospital in 24 hours. But for an almost-centurion? Not so.


Here is what happened:

  • He performed the procedure and claimed it went well. He didn’t notice, however, that she began talking with a crooked mouth—sign of a possible TIA (mini-stroke).

  • A neurologist ordered a CAT scan to look for stroke damage. (Although she did not have a stroke, the droopy lip persists.)

  • She spent five days in the hospital, then the urologist sent her home without regard for physical therapy and with a catheter in place. (Geriatric patients lose muscle tone very quickly lying in bed and require rehabilitative therapy.)

  • Two days home, she came down with pneumonia-like symptoms and had to go back into the hospital.

  • The internist treated her chest congestion and she stayed in the hospital for another five days.

  • While she was in the hospital, the urologist removed the catheter and released her (at our insistence) to a rehab center.

  • At 11 p.m. the evening of her release, she was sent to the ER with severe bladder spasms.

  • She was readmitted to the hospital, and two days later, the urologist performed a second major procedure to undo part of his surgery in order to relieve the bladder spasms. (That is major surgery No. 2 within 10 days.)

  • Three days later, still in the hospital, she again experienced bladder spasms. The urologist took her in for her third major surgery to undo everything he should not have done in the first place.

  • She was finally released to go to the rehab center—still with a catheter.

The prognosis? She may require a permanent catheter—a condition much worse than she had had prior to the first surgery.

Three major surgeries within less than three weeks. Almost three weeks in the hospital. Weeks to be spent in rehab. And possibly a major physical limitation.


And we wonder why our healthcare bills are so high!


Was that doctor a namby-pamby—unable to say “no” to a patient?


Was he ignorant of the special needs of the elderly?


Or was he just money-hungry and wanted to take Medicare and her excellent insurance for all it would pay?


I don’t know the surgeon’s motivations. All I know is that I am angry. I am not opposed providing good quality healthcare to the elderly. I am opposed to doctors’ doing needless procedures whose risks outweigh the benefits.


This blog entry did not have anything to do with communication, but I felt a need to write it.


Until next time,
Linda Segall
Segall Enterprises: Writing and Editing Solutions

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